title: Prevalence and impact of constipation and bowel dysfunction induced by strong opioids: a cross-sectional survey of 520 patients with cancer pain: DYONISOS study.
abstract: OBJECTIVE
  To describe the prevalence of opioid-induced constipation (OIC) in patients with cancer pain according to the Knowles-Eccersley-Scott symptom score (KESS), the different symptoms of opioid-induced bowel dysfunction (OIBD), and to assess the impact of OIBD on patient's quality-of-life.
  
  
  METHODS
  A cross-sectional observational study, using the KESS questionnaire and the physician's subjective assessment of constipation, and other questionnaires and questions on constipation, OIBD, and quality-of-life, carried out on 1 day at oncology day centres and hospitals.
  
  
  RESULTS
  Five hundred and twenty patients were enrolled at 77 centres in France; 61.7% of patients (n = 321) showed a degree of constipation that is problematic for the patient according to KESS (between 9-39). Even more patients, 85.7% (n = 438), were considered constipated according to the physician's subjective assessment-despite laxative use (84.7% of patients). Quality-of-life was significantly reduced in constipated vs non-constipated patients for both PAC-QoL (p < 0.0001 for total score and each dimension) and the SF-12 questionnaires (statistically significant for all dimensions except physical state and role physical). OIC and OIBD led to hospitalization (16% of patients), pain (75% of patients), and frequent changes in opioid and laxative treatment.
  
  
  CONCLUSIONS
  This cross-sectional study, in a selected population of cancer patients, has measured prevalence and impact of OIBD. Further confirmation could be sought through the use of longitudinal studies, and larger populations, such as non-cancer pain patients treated with opioids.
  
  
  CONCLUSIONS
  Cancer patients taking opioids for pain are very frequently constipated, even if they are prescribed laxatives. This leads to relevant impairments of quality-of-life.
authors.affiliation: Hôpital Bichat , Paris , France.
authors.forename: L
authors.initials: L
authors.lastname: Abramowitz
authors.forename: N
authors.initials: N
authors.lastname: Béziaud
authors.forename: L
authors.initials: L
authors.lastname: Labreze
authors.forename: V
authors.initials: V
authors.lastname: Giardina
authors.forename: C
authors.initials: C
authors.lastname: Caussé
authors.forename: B
authors.initials: B
authors.lastname: Chuberre
authors.forename: F A
authors.initials: FA
authors.lastname: Allaert
authors.forename: S
authors.initials: S
authors.lastname: Perrot
mesh_terms: D000368:Aged; D000701:Analgesics, Opioid / Q000009:adverse effects* / Q000627:therapeutic use; D003248:Constipation / Q000139:chemically induced* / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D005260:Female; D005769:Gastrointestinal Motility / Q000187:drug effects; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications*; D009293:Opioid-Related Disorders / Q000453:epidemiology*; D010146:Pain / Q000188:drug therapy / Q000209:etiology; D015995:Prevalence; D011788:Quality of Life; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
chemical_list: D000701:Analgesics, Opioid